CARDIOVASCULAR AND ADRENERGIC EFFECTS OF CIGARETTE-SMOKING DURING IMMEDIATE NON-SELECTIVE AND SELECTIVE BETA-ADRENOCEPTOR BLOCKADE IN HUMANS

Abstract. The cardiovascular and adrenergic responses to cigarette smoking during acute selective and non‐selective beta adrenoceptor blockade were studied in seven young healthy volunteers in a double blind cross‐over fashion. Heart rate, arterial blood pressure, forearm blood flow and plasma levels of adrenaline and noradrenaline were determined before and during the terminal 5 min period of 15 min smoking test. During smoking, plasma concentrations of adrenaline increased markedly and evenly by approximately 0.3 ng/ml in all three experimental sessions. Plasma concentrations of noradrenaline remained unchanged. Propranolol, a non‐selective beta blocker, caused a marked rise in diastolic and mean blood pressure and forearm vascular resistance during smoking. This response was not seen in the control series or after selective beta‐1 blockade with atenolol. This difference is attributable to propranolol's blockade of adrenaline's vasodilating effect mediated by beta‐2 receptors in the resistance vessels. Furthermore, atenolol attenuated the systolic blood pressure and tachycardiac responses induced by cigarette smoking by comparison with placebo. This study suggests that selective beta‐1 blockers are preferable in the management of patients who are habitual smokers. Copyright © 1979, Wiley Blackwell. All rights reserved